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Short-course oral corticosteroids when required in severely uncontrolled asthma; Step 5: Further worsening of symptoms and increased occurrence of exacerbations . Add-on long-acting muscarinic antagonists; Refer for phenotypic assessment with or without biologic therapy; Consider high dose inhaled corticosteroids and formoterol maintenance therapy
EXHALE-2: [5] a global Phase III clinical trial to evaluate the efficacy and safety of dexpramipexole as an add-on oral therapy in participants with inadequately controlled eosinophilic asthma, is currently recruiting people ≥12 years old with a documented physician diagnosis of asthma who require medium to high dose inhaled corticosteroids ...
Budesonide/formoterol, sold under the brand name Symbicort among others, is a fixed-dose combination medication used in the management of asthma or chronic obstructive pulmonary disease (COPD). [2] It contains budesonide, a steroid; and formoterol, a long-acting β 2-agonist (LABA). [2]
Budesonide, sold under the brand name Pulmicort, among others, is a steroid medication. [8] It is available as an inhaler, nebulization solution, pill, nasal spray, and rectal forms. [8] [9] The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease (COPD).
Fluticasone propionate, sold under the brand names Flovent and Flonase among others, is a glucocorticoid steroid medication. [8] When inhaled it is used for the long term management of asthma and COPD. [8] In the nose it is used for hay fever and nasal polyps. [9] [10] It can also be used for mouth ulcers. [11] It works by decreasing inflammation.
When combined with inhaled steroids, β adrenoceptor agonists can improve symptoms. [1] [2] In children this benefit is uncertain and they may be potentially harmful. [2]They should not be used without an accompanying steroid due to an increased risk of severe symptoms, including exacerbation in both children and adults. [3]
Tiotropium is used as maintenance treatment of chronic obstructive pulmonary disease (COPD). [16] [17] It may also be used as an add-on therapy in people with moderate-to-severe asthma on medium to high dose inhaled corticosteroids (ICS).
While the use of inhaled steroids and long-acting beta2‑adrenergic agonists are recommended for the resulting improvement in control of symptoms of asthma, [10] concerns have been raised that salmeterol may increase the risk of death due to asthma, and this additional risk is not reduced by the addition of inhaled steroids. [11]